C-reactive protein predicts complications in community-associated S. aureus bacteraemia: a cohort study

BMC Infect Dis. 2021 Apr 1;21(1):312. doi: 10.1186/s12879-021-05962-7.

Abstract

Background: Staphylococcus aureus (S. aureus) bacteraemia is increasingly acquired from community settings and is associated with a mortality rate of up to 40% following complications. Identifying risk factors for complicated S. aureus bacteraemia would aid clinicians in targeting patients that benefit from expedited investigations and escalated care.

Methods: In this prospective observational cohort study, we aimed to identify risk factors associated with a complicated infection in community-onset S. aureus bacteraemia. Potential risk factors were collected from electronic medical records and included: - patient demographics, symptomology, portal of entry, and laboratory results.

Results: We identified several potential risk factors using univariate analysis. In a multiple logistic regression model, age, haemodialysis, and entry point from a diabetic foot ulcer were all significantly protective against complications. Conversely, an unknown entry point of infection, an entry point from an indwelling medical device, and a C-reactive protein concentration of over 161 mg/L on the day of admission were all significantly associated with complications.

Conclusions: We conclude that several factors are associated with complications including already conducted laboratory investigations and portal of entry of infection. These factors could aid the triage of at-risk patients for complications of S. aureus bacteraemia.

Keywords: C-reactive protein; Complications; Epidemiology; S. aureus bacteraemia.

MeSH terms

  • Adult
  • Aged
  • Bacteremia / complications
  • Bacteremia / diagnosis*
  • Bacteremia / microbiology
  • C-Reactive Protein / analysis*
  • Cohort Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Pneumonia / complications
  • Pneumonia / diagnosis
  • Prospective Studies
  • Risk Factors
  • Skin Diseases / complications
  • Skin Diseases / diagnosis
  • Staphylococcus aureus / isolation & purification*

Substances

  • C-Reactive Protein